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23 Cards in this Set
- Front
- Back
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supplied by the inferior thyroid artery
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Cervical esophagus
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supplied by the left gastric artery and inferior phrenic arteries
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Abdominal esophagus
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Lymphatic drainage of the Esophagus
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upper 2/3 drains cephalad , lower 1/3 drains caudad
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Type of muscle in the upper esophagus?
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striated muscle
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Type of muscle in the lower esophagus?
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smooth muscle
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Right vagus nerve
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travels on anterior portion of stomach; goes to liver and biliary tree
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Left vagus nerve
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travels from right to left in chest at upper 1/3 of mediastinum; inserts into left subclavian vein
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Thoracic duct
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most common site of esophageal perforation
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Cricopharyngeus muscle
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How far is the upper esophageal sphincter from incisors
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15cm
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Upper esophageal sphincter,
what is the inervation and muscle? |
cricopharyngeus muscle
(circular muscle, prevents air swallowing); has recurrent laryngeal nerve innervation |
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Lower esophageal sphincter distance from incisors
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40cm
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Normal LES pressure at rest
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10-20 mm Hg
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Anatomic areas of narrowing of the Esophagus
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1. Cricopharyngeus muscle
2. Compression by the left mainstem bronchus and aortic arch 3. Diaphragm |
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Surgical approach to the esophagus
-Cervical esophagus |
left thorocotomy
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Procedure of choice for dysphagia and odynophagia (better at picking up masses)
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Barium swallow
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Procedure of choice for heartburn
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Endoscopy
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Tx and Dx for Meat impaction
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Dx and Tx: endoscopy
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Possible etiology and tx Cervical esophageal dysphagia
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Plummer-Vinson syndrome; usually due to web;
Fe-deficient anemia. Tx: dilation, Fe; need to screen for oral CA |
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caused by increased pressure during swallowing
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Zenker's diverticulum
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a false diverticulum - posterior
• Occurs between the cricopharyngeus and pharyngeal constrictors • Symptoms: upper esophageal dysphagia, choking, halitosis |
Zenker's diverticulum
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Dx: for Zenker's diverticulum
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barium swallow studies, manometry; risk for perforation with EGD and Zenker's
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Tx: for Zenker's diverticulum
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cricopharyngeal myotomy (key point); Zenker's itself can either be resected or
suspended (removal of diverticula not necessary) • Left cervical incision; leave drains in; esophagogram POD #1 |
